Effect of a Consignment Policy on Outcomes of Orthopedic Emergency Trauma Patients in a Tertiary Hospital

Abstract

Objectives. Implants for traumatic orthopedic injuries are costly, and usually borne by the patient. We determined whether a consignment policy decreases morbidity and mortality rates, decreases length of stay, and decreases total expenditure of our patients.

Methods. This is an ambispective cohort study comparing patients whose orthopedic implant surgeries were done before consignment policy and thus paid for out-of-pocket (Group A), and patients whose surgeries were done under the policy, and whose implants were paid for by hospital funding (Group B). Patient records and hospital bills were reviewed. A total of 206 patients were included in the study, and we gathered data from department and hospital records regarding the incidence of morbidity, mortality, length of stay, and total hospital expenditure.

Results. In this study, we demonstrate no difference in the incidence of morbidities and mortalities between the two groups. There was also no significant difference in the total hospital expenditure of both. There is a slightly shorter preoperative stay, and significantly longer postoperative and total hospital stays for Group B patients.

Conclusion. The consignment policy, in its first year of implementation, demonstrated no difference in the incidence of morbidity and mortality, or total hospital expenditures. Further long-term studies may be undertaken to improve accuracy of results.